BP levels on the rise during the COVID-19 pandemic

Among the many damages that COVID-19 pandemic has brought about, researchers found that increase in blood pressure levels (BP) was one of them, at least among US adults — which could have far reaching health consequences in the long term.

“We know that even small rises in BP increase one’s risk of stroke and other adverse cardiovascular disease events,” said lead author Dr Luke Laffin from Cleveland Clinic in Cleveland, Ohio, US.

“At the start of the pandemic, most people were not taking good care of themselves. Increases in BP were likely related to changes in eating habits, increased alcohol consumption, less physical activity, decreased medication adherence, more emotional stress, and poor sleep,” he suggested.

The longitudinal study involved 464,585 participants (mean age 45.7 years, 53.5 percent women) in an employer-sponsored wellness programme who had their BP measured annually from 2018–2020. [Circulation 2021;doi:10.1161/CIRCULATIONAHA.121.057075]

Compared with prepandemic period in 2019, both systolic and diastolic BP levels were significantly higher during the pandemic (defined as April to December 2020) — with monthly increases of 1.10–2.50 mm Hg for systolic BP and 0.14–0.53 mm Hg for diastolic BP (p<0.0001 for both).

In accordance, more participants (26.8 percent) were re-categorized to a higher BP category compared with only 22 percent of participants who shifted to a lower BP category.

For both systolic and diastolic BP, the increases were more pronounced in women than men.

When stratified by age, older participants saw a greater increase in systolic BP than younger ones, while younger individuals had a larger increase in diastolic BP.

“From a public health perspective, during a pandemic, getting vaccinated and wearing a mask are important. However, the results of our research reinforce the need to also be mindful of chronic health conditions such as the worsening of BP,” stated Laffin.

“Even in the midst of the pandemic, it’s important to pay attention to your BP and your chronic medical conditions,” he advised. “Get regular exercise, eat a healthy diet, and monitor your BP and cholesterol. See your doctor regularly to learn how to manage your cardiovascular risk factors.”

Follow-up on these participants is currently ongoing to elucidate if the trend also extend to 2021, which according to the researchers, might predict a forthcoming wave of myocardial infarctions and strokes.

“Unfortunately, this research confirms what is being seen across the country – the COVID-19 pandemic has had and will continue to have long-reaching health impacts across the country and particularly related to uncontrolled hypertension,” said Dr Eduardo Sanchez,  who is chief medical officer for prevention for the American Heart Association.

As the study population was limited to only participants in the employee wellness programme, the findings may not be generalizable to other populations. Also, the main cause for the higher BP observed during pandemic was unclear, and likely to be multifactorial, according to the researchers.